Chapter 44 - GERD (Questions)

The nurse is admitting a client with a stroke who is unconscious and unresponsive to stimuli and learns from the client's family that the client has a history of gastro-esophageal reflux disease (GERD). Which of the following assessment parameters should the nurse plan to assess frequently? a. Apical pulse b. Bowel sounds c. Breath sounds d. Abdominal girth

ANS: C Because GERD may cause aspiration, the unconscious client is at risk for developing aspiration pneumonia. Bowel sounds, abdominal girth, and apical pulse will not be affected by the client's stroke or GERD and do not require more frequent monitoring than the routine.

Which of the following information should the nurse include when teaching a client with newly diagnosed gastro-esophageal reflux disease (GERD)? a. "Peppermint tea may be helpful in reducing your symptoms." b. "You should avoid eating between meals to reduce acid secretion." c. "Vigorous physical activities may increase the incidence of reflux." d. "It will be helpful to keep the head of your bed elevated on blocks."

ANS: D Elevating the head of the bed will reduce the incidence of reflux while the client is sleeping. Peppermint will lower LES pressure and increase the chance for reflux. Small, frequent meals are recommended to avoid abdominal distension. There is no need to make changes in physical activities because of GERD.

The nurse is assessing a client with gastro-esophageal reflux disease (GERD) who is experiencing increasing discomfort. Which of the following client statements indicate that additional client education about GERD is needed? a. "I take antacids between meals and at bedtime each night." b. "I sleep with the head of the bed elevated on 10-cm blocks." c. "I quit smoking several years ago, but I still chew a lot of gum." d. "I eat small meals throughout the day and have a bedtime snack."

ANS: D GERD is exacerbated by eating late at night, and the nurse should plan to teach the client to avoid eating at bedtime. The other client actions are appropriate to control symptoms of GERD.

The nurse is teaching a client with gastro-esophageal reflux disease (GERD) about recommended dietary modifications. Which of the following diet choices for a snack 2 hours before bedtime indicates that the teaching has been effective? a. Chocolate pudding b. Glass of low-fat milk c. Peanut butter sandwich d. Cherry gelatin and fruit

ANS: D Gelatin and fruit are low fat and will not decrease lower esophageal sphincter (LES) pressure. Foods like chocolate are avoided because they lower LES pressure. Milk products increase gastric acid secretion. High-fat foods such as peanut butter decrease both gastric emptying and LES pressure.